I was treated with HIFU in Toronto about four years ago. PSA tests have all been good until a month ago 0.2, a month ago it came back 1.5, did another PSA test Tuesday and came back 1.7. Just wondering what is up, taking another test in a month. My initial gleason was a 9 all my bones came back clean during the intitial treatment. ???

So little is known about the long term data regarding HIFU especially with the newer techniques. I am only a passive observer of HIFU, so maybe others may help. I am far more in tune with high Gleason's and relapses. And you are both apparently. From what I understand about HIFU you should have virtually all of the options for localized therapy still available to you including another shot at HIFU.

I have however been observing recent studies on HIFU that indicate that a G9 patient is not a good candidate for that therapy. If that is true, then have you explored other means of controlling this?

During the 4 previous years, what was your PSA typically after the HIFU procedure? Also, surprised they did HIFU with you being a Gleason 9, I don't know much about it, but the criteria I have read typically shows it not being done for any Gleason over 8. Not many here ever had HIFU done, but many curious about it since it will at some point get FDA approval here in the US.

Recent studies on HIFU release from Japan and France indicate reoccurrance rates higher than conventional therapies. More alarming is that the 5 year reoccurance rates remain steady and don't drop as they do with conventional therapies. It is also very unusual for a G9 cancer to be treated with HIFU. I think your best bet would be to see an oncologist as secondary local treatments for G9's are usually not very successful.JohnT65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

goodlife, you're right about surgery being on the table; at least as a possibility.

I talked with a da Vinci surgeon in Cincinnati who had removed a prostate that had been HIFUed twice. He said it wasn't a pretty sight, and not an easy surgery, but it had gone well with a good outcome.